| NPI | 1194151498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE BODDIE Physician/Owner 478-452-6999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 027966) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2021-02-05 |